Surf City Nights (DOC)

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					                                                    Surf City Nights Application

            Beginning Date:   _______________                          Ending Date:    ________________

     1.     Name of Business:________________________________________________________________________________

     2.     Owner/Owners: __________________________________________________________________________________

     3.     Address________________________________ City____________________ State_________ Zip Code____________

     4.     Contact Number: __________________Cell Number: _________________E-Mail____________________________

     5.     Business Web Address_____________________________________________________________________________

     6.     Contact Person at Event Site____________________________________Cell Number __________________________

     7.     Is this a non-profit organization? _________ If yes, you must provide IRS#__________________________________

     8.     Complete Description of Activity____________________________________________________________________


          *Please attach a copy of your Huntington Beach City license, Liability Waiver, and Health inspector permit if required*

          It is the applicant’s responsibility to be familiar with the Surf City Nights Rules and Regulations. Non –compliance
     with the rules and regulations may result in permit revocation of the applicant from the event.

          The undersigned certifies that she/he is authorized to 1) execute on behalf of the group/business and 2) accept legal
     process on behalf of the group/business. The undersigned also agrees to indemnify and hold harmless the City of
     Huntington Beach, Downtown Business Improvement District, liabilities, costs and expenditures, including attorney’s fees
     and costs of defense, which may occur by reason of use of the streets during Surf City Nights.

     NOTE: Space is issued once an application is approved and appropriate fees are paid. Make checks payable to the
     Huntington Beach Downtown Business Improvement District (HBDBID).

     __________                    __________________________________            ________________________________________
       Date                                  Signature                                   Please print name

          * It is the applicant’s responsibility to call the BID Office on Monday, after 9:00am to confirm approval, modifications
     or denial of the application. In the event of an official cancellation due to rain, it is also applicant’s responsibility to
     reschedule with the Surf City Nights Coordinator.

                                               DO NOT WRITE BELOW THIS LINE


COMMITTEE COMMENT/RECOMMENDATION_____________________________________________________________

                                                             Remit to:
                                                       315 3rd Street, Suite E
                                                   Huntington Beach, CA 92648
                                               (714) 536-8300; Fax #: (714) 536-8383

Check amount enclosed_______________                Check # ______________                                     ____Permit on File
Assigned Space # _____________________

Surf City Nights Application.doc

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